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Prolongation of the QTc interval is associated with an increased risk of cardiovascular diseases: The Hoorn study
Sabrina J G C Welten1, Amber A van der Heijden1, Sharon Remmelzwaal2
1Amsterdam UMC location Vrije Universiteit Amsterdam, Department of General Practice, de Boelelaan 1117, Amsterdam, Netherlands; Amsterdam Public Health Research Institute, Health Behaviors & Chronic Diseases, Amsterdam, the Netherlands.
Insights
Prolonged QTc interval on ECG is linked to cardiovascular disease (CVD) risk. This association was not modified by glucose tolerance status in a population-based study.
Area of Science:
- Cardiology
- Clinical Research
- Epidemiology
Background:
- Prolonged heart rate-corrected QT interval (QTc) on electrocardiograms (ECG) is suspected to increase cardiovascular disease (CVD) risk, but evidence remains inconsistent.
- Investigating the link between baseline QTc prolongation and CVD morbidity/mortality is crucial for understanding CVD risk factors.
Purpose of the Study:
- To determine if baseline QTc interval prolongation is associated with CVD morbidity and mortality.
- To examine if glucose tolerance status modifies the association between QTc interval and CVD outcomes.
Main Methods:
- A population-based cohort study (Hoorn Study) analyzed 487 participants with a mean follow-up of 10.8 years.
- Cox regression models assessed the association between QTc quartiles and CVD events, adjusting for multiple risk factors.
- Stratified analyses were performed based on glucose tolerance status.
Main Results:
- A 10 ms increase in QTc interval was associated with increased CVD risk (HR 1.06; 95% CI: 1.02-1.10), particularly for heart failure (HR 1.12; 95% CI: 1.06-1.19) and stroke (HR 1.07; 95% CI: 1.01-1.13).
- No significant modification of the QTc-CVD association was observed across different glucose tolerance statuses (P > 0.2).
Conclusions:
- Baseline QTc interval prolongation is a significant risk factor for general CVD morbidity and mortality.
- Glucose tolerance status does not appear to influence the relationship between QTc prolongation and cardiovascular outcomes.
Background/Objective:
Prolonged heart rate-corrected QT interval (QTc) on the electrocardiogram (ECG) is maybe associated with the occurrence of cardiovascular diseases (CVD), but the evidence is inconsistent. Therefore, we investigated whether baseline prolongation of the QTc interval is associated with CVD morbidity and mortality and its subtypes and whether glucose tolerance modifies this association in a population-based cohort study with a mean follow-up of 10.8 years.
Methods:
We analyzed a glucose tolerance stratified sample (N = 487) from the longitudinal population-based Hoorn Study cohort (age 64 ± 7 years, 48% female). Cox regression was used to investigate the association between sex-specific baseline QTc quartiles and CVD morbidity and mortality. The risk was also estimated per 10 ms increase in QTc. All analyses were adjusted for age, sex, smoking status, systolic blood pressure, prevalent CVD, glucose tolerance status, hypertension and total cholesterol. In addition, stratified analyses were conducted for glucose tolerance status.
Results:
During a mean follow-up of 10.8 years, 351 CVD events were observed. The adjusted hazard ratios (95% CI) for each 10 ms increase in QTc interval were 1.06 (95% CI: 1.02-1.10) for CVD, 1.06 (95% CI: 0.97-1.15) for acute myocardial infarction, 1.07 (95% CI: 1.01-1.13) for stroke, 1.12 (95% CI: 1.06-1.19) for heart failure, 1.04 (95% CI: 0.96-1.12) for peripheral arterial disease and 1.01 (95% CI:0.95-1.08) for coronary heart disease. Glucose tolerance status did not modify the association (P > 0.2).
Conclusion/Interpretation:
Prolongation of the QTc interval is associated with morbidity and mortality due to general CVD. Glucose tolerance status did not modify these associations.
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